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November 6, 1996

Experts Say AIDS Pain 'Dramatically Undertreated'

JAMA. 1996;276(17):1369-1370. doi:10.1001/jama.1996.03540170013005

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DESPITE ever more sophisticated strategies for treating human immunodeficiency virus (HIV) disease, researchers are finding that many patients suffer needlessly because physicians fail to recognize and alleviate AIDS-related pain.

Studies show that although people with HIV infection and AIDS suffer pain comparable to that experienced by cancer patients, their pain is "dramatically undertreated, even in academic centers with a focus on HIV care," said William Breitbart, MD, at a recent international congress on pain held in Vancouver, British Columbia.

"The story of pain in AIDS has been a story of neglect," noted Breitbart, of Memorial Sloan-Kettering Cancer Center, New York, NY. And the problem may be exacerbated by pressures of managed care that result in greater numbers of people with HIV and AIDS being cared for by primary care physicians, many of whom have little training or experience in managing chronic pain.

"Most physicians haven't been trained in